Known in the art are a number of various devices for establishing compression anastomoses of hollow organs of the gastrointestinal tract by compressing the tissues in the anastomotic zone with such a force that results in rejecting the devices over a period of time and their natural removal (cf., e.g., "Sutureless anastomoses in surgery of the gastrointestinal tract with and without permanent magnetic field" by N. N. Kanshin et al. Records of pathology, 1978, v. XL, issue 8, pp. 56.varies.61 (In Russian); "On some regularities governing the tissue compression and regeneration processes involved in establishing sutureless anastomoses of hollow organs of the gastrointestinal tract" by L. A. Piruzian et al. Proceedings of the USSR Academy of Sciences, Biological series, 1979, No. 1 pp. 13-17 (in Russian)). These devices are made of two flat plates of a magnetic material, which attract each other, or two flat rings likewise attracting each other. However, the abovesaid devices made as magnetic plates fail to provide primary patency of the alimentary tract, while the magnetic rings are unsuitable for the purpose as practical experience has demonstrated, due to high stiffness and large weight.
One more suturing instrument disclosed in USSR Inventor's Certificate No. 571,254 is known to comprise a tubular body, a staple head linked thereto and provided with staple slots, a circulary knife, a detachable thrust head with depressions and a movable screw locking the head in position, soft elastic spacers shaped as circular troughs and located on the suturing surfaces of the staple and thrust heads.
The abovesaid instrument is capable of establishing compression anastomoses on the organs of the digestive tract using end-to-end or end-to-side technique alone. The instrument is unsuitable for establishing latera gastrointestinal and interintestinal compression anastomoses, which are frequently encountered in modern surgical practice.
An instrument protected by U.S. Pat. No. 3,079,606 is known for establishing lateral gastrointestinal and interintestinal anastomoses by the side-to-side technique.
The instrument is known to comprise hinge-joined supporting and staple bodies having longitudinal jaws, the former body carrying a staple magazine and an ejector to feed the staples from the magazine for suturing, and a knife for making a longitudinal incision along the length of the applied sutures applied, while the latter body has a die for bending the staples in the course of suturing. However, this instrument suffers from a number of disadvantages, stemming largely from its being not adapted for establishing lateral compression anastomoses.
The afore-mentioned instrument allows springy elastic spacers to be mounted on its jaws. However establishing a lateral compression anastomosis requires incisions or punctures for the jaws to pass through, which are then to be stitched up manually. This deleteriously the quality of the compression anastomosis thus established. Though the zone of the compression suture features good biological tightness and provides for good asepsis in the course of tissue healing, the adjacent zone of manual suture, even when possessing high mechanical strength, suffers from disturbed biological tightness thereof, whereby inflammatory and adhesion-forming process are liable to develop. As a result, the potency of the established anastomosis is reduced on which account cicatricial tissue are later liable to form in the anastomotic zone.
Moreover, in order to withdraw the instrument jaws from the interior of the hollow organs involved after their walls have been sutured with staples together with the elastic spacers, the latter must be separated from the jaws, which provide to be difficult with a given construction of the instrument. Thus, one has to enlarge the punctures made in the wall of the organs being anastomosed, in order to intersect the straps holding the spacers to the instrument jaws. This of course impairs the quality of the compression anastomosis established.
Apart from a quality formation of anastomoses on the organs of the gastrointestinal tract, one more important task of a surginal intervention in these organs is to stitch up the mesentery, which needs establishing of any anastomosis. Besides, stitching up the mesentery following the excision of morbidly changed intestines involves considerable lengths of the gastrointestinal tract, which may amount to a few scores of centimeters.
Such a case requires, apart from reliable constriction of different-size blood vessels running through the mesentery, also application of longer sutures, i.e., needs higher productivity of the suturing instrument. This makes it possible to cut down the operating time several fold.
The known instrument as per U.S. Pat. No. 3,079,606 when applied for stitching up the mesentery with the use of elastic spacers, requires some additional manipulations with the cutting instruments in order to separate the spacers from the instrument jaw, and turns of the suturing instrument for the spacers to take out of the bottom jaw, which is far from being practicable at every time, e.g., deeply in the operative wound and affects adversely the productivity of the instrument.